子宫内膜癌患者宫腔镜电切术治疗后复发的危险因素分析

Analysis of Risk Factors for Recurrence After Hysteroscopic Electroresection for Endometrial Cancer Patients

目的探讨子宫内膜癌患者宫腔镜电切术治疗后复发的相关危险因素,为临床降低子宫内膜癌复发风险提供重要依据。方法回顾性分析行宫腔镜电切术治疗的96例子宫内膜癌患者的临床资料,依据复发与否分为复发组及未复发组。收集两组患者年龄、体质量指数、病理分期、病理分级、肌层浸润深度、病理类型、腹腔细胞学检查、基础疾病史、肿瘤直径等一般资料。先进行单因素分析,之后将具有统计学差异的变量纳入多因素Logistic回归模型,采用逐步回归筛选变量,最终获取宫腔镜电切术治疗子宫内膜癌患者后复发的独立影响因素。结果96例子宫内膜癌患者,术后出现复发23例,术后复发率为23.96%(23/96);两组淋巴结转移、病理分级、肌层浸润深度、术后联合激素类药物情况及肿瘤直径相比,差异有统计学意义(P<0.05);多因素分析显示:有淋巴结转移、病理分级G 3、肌层浸润深度≥1/2、术后未联合激素类药物及肿瘤直径>2 cm是子宫内膜癌患者术后复发的高危因素(P<0.05,且OR>1)。结论淋巴结转移、病理分级、肌层浸润深度、术后联合激素类药物及肿瘤直径是影响子宫内膜癌术后复发的高危因素,临床应采用针对性措施干预,以降低宫腔镜电切术后复发风险。

Objective To explore the risk factors of recurrence after hysteroscopic resection in endometrial cancer patients and provide an important basis for reducing the risk of endometrial cancer recurrence.Methods The clinical data of 96 endometrial cancer patients treated by hysteroscopic electroresection were analyzed retrospectively,and divided into recurrence and non recurrence.General data on age,body mass index,pathological stage,grade,pathological grade,depth of muscle layer invasion,pathological type,abdominal cytology,history of underlying disease,and tumor diameter were collected.Univariate analysis was performed,and then variables with statistical differences were included in the multivariate logistic regression model,and progressive regression was used to screen variables to finally obtain independent influencing factors for recurrence after hysteroscopic treatment of endometrial cancer patients by resection.Results In 96 cases of endometrial cancer recurrence,23 cases had postoperative recurrence,recurrence rate was 23.96%(23/96);Lymph node metastasis,pathological grade,muscle invasion depth,postoperative combined hormone status and tumor diameter of the 2 groups had statistical difference(P<0.05);multivariate analysis showed that lymph node metastasis,pathological grade G 3,muscle invasion depth 1/2,and tumor diameter>2 cm were the risk factors for postoperative recurrence in patients with endometrial cancer(P<0.05,and OR>1).Conclusion Lymph node metastasis,pathological grade,depth of myometrial invasion,postoperative combined hormone drugs and tumor diameter are high risk factors affecting postoperative recurrence of endometrial cancer,and targeted intervention should be adopted to reduce the risk of recurrence after hysteroscopic resection.